글루코코르티코이드
Glucocorticoids
Corticosteroids
다른 이름: Prednisone · Dexamethasone · Hydrocortisone · Methylprednisolone · Kenalog · Recicort · Glucocorticosteroids · Triamcinolone acetonide
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Anti-inflammatory (Prednisolone equivalent) | 0.5-1.0 mg/kg | PO | q12h to q24h | Taper to lowest effective alternate-day dose | 🌍 EU |
| Immunosuppressive (Prednisolone equivalent) | 2.0-4.0 mg/kg | PO | q24h (divided q12h initially) | Taper slowly over weeks to months | 🌍 EU |
- Anti-inflammatory (Prednisolone equivalent): Doses are highly variable depending on the specific glucocorticoid used.
- Immunosuppressive (Prednisolone equivalent): Monitor closely for severe adverse effects at these doses.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Anti-inflammatory (Prednisolone equivalent) | 1.0-2.0 mg/kg | PO | q12h to q24h | Taper to lowest effective alternate-day dose | 🌍 EU |
| Immunosuppressive (Prednisolone equivalent) | 2.0-4.0 mg/kg | PO | q12h to q24h | Taper slowly over weeks to months | 🌍 EU |
- Anti-inflammatory (Prednisolone equivalent): Cats require higher doses than dogs and should receive prednisolone, not prednisone.
- Immunosuppressive (Prednisolone equivalent): Monitor for signs of diabetes mellitus.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
글루코코르티코이드는 포유류의 거의 모든 세포 유형과 시스템에 깊은 영향을 미치는 광범위한 스테로이드 호르몬 계열입니다. 수의학에서는 주로 다음 네 가지 광범위한 용량 범위와 적응증에 사용됩니다:
- 생리적 대체 요법: 부신 피질 기능 저하증(예: 애디슨병) 환자용.
- 항염증: 알레르기 상태, 호흡기 질환(천식), 피부 질환 및 골관절염 관리.
- 면역 억제: 면역 매개성 용혈성 빈혈(IMHA), 혈소판 감소증, 천포창, 전신성 홍반성 루푸스와 같은 자가면역 질환용.
- 항종양: 특정 종양(예: 림프종)에서 세포 독성제로 사용.
임상 요점: 고양이는 일반적으로 개보다 동일한 임상 효과를 얻기 위해 더 높은 용량이 필요하지만 부작용 발생에 대한 저항력이 더 강한 편입니다. 반대로 개는 글루코코르티코이드에 매우 민감하여 만성적으로 사용할 경우 의인성 부신피질기능항진증(쿠싱 증후군)이 쉽게 발생합니다.
작용 기전
Glucocorticoids exert their effects primarily by binding to cytosolic glucocorticoid receptors (GR). The receptor-ligand complex translocates to the nucleus, where it binds to glucocorticoid response elements (GREs) on DNA, altering gene transcription (transactivation and transrepression).
- Anti-inflammatory Pathway: They induce the production of lipocortin (annexin-1), which inhibits phospholipase A2. This blocks the release of arachidonic acid from cell membranes → dramatically decreasing the synthesis of both prostaglandins and leukotrienes.
- Immune Suppression: They inhibit macrophage function, decrease circulating T-lymphocytes, suppress inflammatory cytokines (IL-1, IL-6, TNF-alpha), and inhibit the complement cascade.
- Metabolic Effects: Stimulate gluconeogenesis, mobilize amino acids, and redistribute adipose tissue, which can lead to insulin resistance.
안전성·주의사항
금기사항
- Systemic fungal infections (unless used for physiologic replacement)
- Intramuscular administration in patients with idiopathic thrombocytopenia
- Known hypersensitivity to the specific compound
- Chronic use of sustained-release injectables for systemic diseases
- Concurrent use with NSAIDs (relative contraindication due to severe GI ulcer risk)
- Pregnant animals
- Renal disease (systemic use)
- Diabetes mellitus (systemic use)
- Corneal ulcers
- Concurrent use of NSAIDs
- Uncontrolled diabetes mellitus
- Late pregnancy (may induce abortion or parturition)
부작용
- Polyuria (PU), polydipsia (PD), and polyphagia (PP)
- Weight gain and fat redistribution
- Panting (especially in dogs)
- Dull, dry haircoat and alopecia
- Vomiting and diarrhea
- Gastrointestinal ulceration
- Elevated liver enzymes (ALP > ALT) and vacuolar hepatopathy (dogs)
- Pancreatitis
- Insulin resistance leading to or worsening diabetes mellitus
- Muscle wasting and weakness
- Behavioral changes (depression, lethargy, viciousness)
- Iatrogenic hyperadrenocorticism (Cushing's syndrome) with chronic use
- Laminitis (horses)
- Hypothalamic-pituitary axis (HPA) suppression
- Adrenal atrophy
- Weight loss (catabolic effect)
- Cutaneous atrophy
- Diarrhoea
- Increased urine glucose levels
- Decreased serum T3 and T4 values
- Impaired wound healing
- Delayed recovery from infections
- Muscle weakness
- Obesity
- Thromboembolic disease
- Polyuria and polydipsia (PU/PD)
- Muscle atrophy and weakness
- Alopecia and thin skin
- Insulin resistance and secondary diabetes mellitus
- Immunosuppression and increased susceptibility to infections
- Hepatomegaly and elevated liver enzymes (steroid hepatopathy in dogs)
주의
Animals receiving systemic glucocorticoids (other than short-term 'burst' therapy) MUST be tapered off the drugs slowly to allow endogenous ACTH and corticosteroid function to return. Abrupt withdrawal can precipitate a life-threatening Addisonian crisis. During periods of stress (e.g., surgery, trauma, severe illness) during the tapering process, additional glucocorticoids should be administered. Use with caution in young, growing animals as it can retard bone growth.
약물 상호작용
May cause hypokalemia when administered concomitantly
May lead to profound muscle weakness in myasthenia gravis patients; discontinue 24h prior if possible
Glucocorticoids may reduce salicylate blood levels; increased risk of GI ulceration
Glucocorticoids may inhibit hepatic metabolism of cyclophosphamide
May mutually inhibit hepatic metabolism, increasing blood levels of both drugs
Increased risk for arrhythmias secondary to glucocorticoid-induced hypokalemia
May cause additive hypokalemia
May increase glucocorticoid metabolism
May potentiate the effects of hydrocortisone and possibly other glucocorticoids
Insulin requirements may increase due to glucocorticoid-induced insulin resistance
May decrease glucocorticoid metabolism
May alter steroid metabolism; higher steroid doses may be necessary to treat mitotane-induced adrenal insufficiency
Significantly increased risk of severe gastrointestinal ulceration
May increase the metabolism of glucocorticoids
May increase the metabolism of glucocorticoids
May increase the metabolism of glucocorticoids
Live attenuated vaccines should be avoided due to augmented virus replication; diminished immune response to all vaccines may occur
Hypokalaemia may develop
Decreased metabolism of corticosteroids
Significantly increased risk of severe gastrointestinal ulceration and perforation.
Increased risk of hypokalemia due to additive potassium-wasting effects.
모니터링
- Weight, appetite, and signs of edema
- Serum and/or urine electrolytes (potassium, calcium, sodium)
- Total plasma proteins and albumin
- Liver enzymes (ALP, ALT, GGT)
- Growth and development in young animals
- ACTH stimulation test (if assessing adrenal recovery or iatrogenic Cushing's)
- Clinical signs of hyperadrenocorticism
- Blood glucose (especially in diabetics)
- Thyroid panel (T3/T4 may decrease)
- Clinical signs of PU/PD and weight gain
- Blood glucose (due to diabetes mellitus risk)
- ACTH stimulation test (to monitor HPA axis suppression)
- Water intake and urine output
- Appetite and body weight
- Blood glucose (especially in cats)
- Liver enzymes (ALP is typically markedly elevated in dogs on steroids)
- Clinical signs of secondary infections (e.g., UTI, pyoderma)
- Gastrointestinal signs (vomiting, melena)
약동학
반감기
흡수
Varies significantly by ester formulation. Sodium succinate/phosphate esters are absorbed very rapidly (minutes). Acetate esters are absorbed moderately (days to weeks). Acetonide esters are absorbed poorly (weeks).
분포
Widely distributed. Unbound glucocorticoids can enter milk and cross the placenta.
대사
Primarily hepatic metabolism.
배설
Metabolites are primarily excreted by the kidneys.
과다투여
Short-term massive overdoses are unlikely to cause acute harmful effects, though one case of acute CNS effects in a dog has been reported (treat supportively). Chronic overdosage leads to serious adverse effects manifesting as iatrogenic hyperadrenocorticism (Cushing's syndrome).
제품
제형
- Oral tablets and liquids
- Injectable solutions (e.g., sodium succinate/phosphate esters for rapid onset)
- Injectable suspensions (e.g., acetate/acetonide esters for sustained release)
- Topical creams, ointments, and sprays
- Ophthalmic drops and ointments
- Injectable: 40 mg/ml suspension for deep i.m., intra-articular or intralesional use
- Topical: Solution containing 1.77 mg/ml with 17.7 mg/ml salicylic acid
- Systemic (Oral/Injectable)
- Local
- Inhaled
- Oral liquids
- Injectable solutions (e.g., sodium phosphate salts)
- Injectable suspensions (e.g., acetate or acetonide salts)
동물용의약품
- Kenalog 40 mg/ml injectable suspension
- Recicort 1.77 mg/ml topical solution
- Prednicare (Prednisolone tablets)
- Dexadreson (Dexamethasone injection)
- Moderin (Methylprednisolone tablets)
인용의약품
- Prednisolone tablets
- Dexamethasone tablets/injection
- Hydrocortisone tablets
규제 현황
투여 중단 기간: cattle meat Varies by specific drug and formulation
Widely approved across member states.
POM-V classification.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store according to specific product labeling, generally at room temperature away from light and moisture.
보호자 정보
중요 경고: 수의사의 특별한 지시가 없는 한 이 약의 복용을 갑자기 중단하지 마십시오. 반려동물의 신체는 이 약을 복용하는 동안 자체 스테로이드 생성을 중단하며, 갑작스러운 중단은 생명을 위협하는 위기를 초래할 수 있습니다.
- 예상되는 변화: 이 약을 복용하는 동안 반려동물(특히 개)이 물을 더 많이 마시고, 소변을 자주 보며, 식욕이 왕성해지는 것은 매우 흔한 일입니다. 항상 신선한 물을 마실 수 있게 하고 배변 기회를 자주 제공하십시오.
- 헐떡임: 개는 과도하게 헐떡일 수 있으며, 이는 흔한 부작용입니다.
- 행동 변화: 일부 반려동물은 무기력해지거나, 우울해하거나, 비정상적으로 짜증을 낼 수 있습니다.
- 수의사에게 연락해야 할 때: 심한 구토, 검고 끈적이는 변(위궤양의 징후), 극도의 쇠약함을 발견하거나 갈증/배뇨 증가를 감당하기 어려워지면 수의사에게 연락하십시오.
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